Taira Koichi, Okazaki Shunsuke, Akiyoshi Kohei, Machida Hirohisa, Ikeya Tetsuro, Kimura Akie, Nakata Akinobu, Nadatani Yuji, Ohminami Masaki, Fukunaga Shusei, Otani Koji, Hosomi Shuhei, Tanaka Fumio, Kamata Noriko, Nagami Yasuaki, Fujiwara Yasuhiro
Department of Gastroenterology, Osaka Metropolitan University Graduate School of Medicine, Osaka 545-8585, Japan.
Department of Clinical Oncology, Osaka City General Hospital, Osaka 534-0021, Japan.
Mol Clin Oncol. 2022 Jul 27;17(3):139. doi: 10.3892/mco.2022.2572. eCollection 2022 Sep.
Bevacizumab is a humanized monoclonal antibody that contains <10% murine protein. To prevent infusion-related hypersensitivity reactions (HSRs), the initial bevacizumab infusion is delivered for 90 min, the second for 60 min and subsequent doses for 30 min. Several previous studies have shown that short bevacizumab infusions are safe and do not result in severe HSRs in patients with colorectal, lung, ovarian and brain cancer. However, the efficacy of short bevacizumab infusions for colorectal cancer management remains unclear. Therefore, to investigate this issue, a prospective multicenter study was conducted using 23 patients enrolled between June 2017 and March 2019. The initial infusion of bevacizumab was for 30 min followed by a second infusion rate of 0.5 mg/kg/min (5 mg/kg over 10 min and 7.5 mg/kg over 15 min. The primary endpoint was progression-free survival (PFS). The overall response and disease control rates were 57 and 87%, respectively. The median PFS time was 306 days (interquartile range, 204-743 days). No HSRs were noted. Adverse events associated with bevacizumab included grade 4 small intestinal perforation and grade 3 stroke in 1 patient each. These results suggest that a short bevacizumab infusion regime comprising an initial infusion for 30 min followed by a second infusion at 0.5 mg/kg/min is safe and efficacious for the management of colorectal cancer.
贝伐单抗是一种人源化单克隆抗体，含鼠蛋白<10%。为预防输注相关的超敏反应（HSR），贝伐单抗首次输注时间为90分钟，第二次为60分钟，后续剂量输注时间为30分钟。此前多项研究表明，对于结直肠癌、肺癌、卵巢癌和脑癌患者，短时间输注贝伐单抗是安全的，不会导致严重的HSR。然而，短时间输注贝伐单抗在结直肠癌治疗中的疗效仍不明确。因此，为研究此问题，开展了一项前瞻性多中心研究，纳入了2017年6月至2019年3月期间的23例患者。贝伐单抗首次输注30分钟，随后以0.5 mg/kg/分钟的速率进行第二次输注（10分钟输注5 mg/kg，15分钟输注7.5 mg/kg）。主要终点是无进展生存期（PFS）。总体缓解率和疾病控制率分别为57%和87%。PFS的中位时间为306天（四分位间距为204 - 743天）。未观察到HSR。与贝伐单抗相关的不良事件包括1例患者发生4级小肠穿孔和1例患者发生3级中风。这些结果表明，一种短时间输注贝伐单抗的方案，即首次输注30分钟，随后以0.5 mg/kg/分钟的速率进行第二次输注，在结直肠癌治疗中是安全有效的。
